We aimed to determine whether the short-term response to biologics in biologic-naïve psoriatic arthritis (PsA) is better in patients initiating biologic treatment early in the disease course.
Methods
PsA patients who started biologic therapy from the year 2000 to 2025 were included for analysis. Patients considered in the early treatment (ET) group if they started biologic therapy within 2 years of PsA diagnosis, otherwise they were considered in the delayed treatment (DT) group. The primary outcome was ≥50% reduction in the Disease Activity Index for Psoriatic Arthritis (DAPSA) score at 6-months. The secondary outcome was Psoriasis Activity and Severity Index (PASI) 75, defined as ≥75% improvement in the PASI score, at 6-months. Logistic regression was used to examine the association between early treatment and disease outcomes at 6-months. Propensity scores were used to account for differences between the groups at the baseline visit.
Results
Of the 228 included patients, 71 patients were in the ET group and 157 patients in the DT group. There were significant differences in the time from PsA diagnosis to biologic treatments over the decades. The propensity score regression adjusted analysis did not suggest a difference in response at 6 months between those treated within 2 years of diagnosis and those treated later.
Conclusion
Short-term response to biologic therapy in patients with PsA does not appear to differ between those treated early or later in the disease course. It remains to be determined whether early treatment prevents progression of joint damage in the longer-term.
